摘要
目的分析儿童轻微脑炎伴胼胝体压部可逆性病变(MERS)的临床表现及影像学特征。方法选取2015年2月—2016年10月唐山市传染病医院和唐山市妇幼保健院收治的MERS患儿10例,分析其临床表现(首发症状、神经系统症状)、实验室检查指标、颅脑磁共振成像(MRI)检查结果和预后。结果 10例患儿中出现复发1例;首发病状为发热6例次,呕吐5例次,咳嗽2例次,腹泻1例次;抽搐6例次(其中抽搐1次者1例次、抽搐2~10次者2例次、抽搐>10次者3例次),阵发性失明/视物不清4例次,意识障碍4例次。10例患儿血培养结果均为阴性,脑脊液常规检查结果无异常;1例患儿白细胞计数和中性粒细胞分数较高,分别为21.9×109/L、75.88%;1例患儿血钠较低,为131 mmol/L。10例患儿颅脑MRI检查示胼胝体压部片状长T1及长T2信号,磁共振弥散加权成像(DWI)呈高信号,其中1例患儿同时存在双侧半卵圆中心及部分颞叶白质对称多发长T1与长T2信号,DWI呈高信号,诊断为Ⅱ型MERS。10例患儿均予以常规抗炎、抗病毒治疗及脱水降颅内压。治疗后随访4个月~2年,10例患儿神经系统均发育正常。结论儿童MERS具有独特的临床表现及影像学特征,但经相应临床治疗后预后良好。
Objective To analyze the clinical manifestations and imaging features of slight encephalitis children complicated with reversible lesions of corpus callosum splenium. Methods A total of 10 slight encephalitis children complicated with reversible lesions of corpus callosum splenium were selected in Tangshan Hospital for Infectious Diseases and Maternal and Child Health Care Hospital of Tangshan from February 2015 to October 2016,then the clinical manifestations（ including initial symptoms and neurological symptoms）, laboratory examination results, cerebral MRI examination results and prognosis were analyzed. Results Of the 10 children,1 child occurred relapse,fever occurred 6 case-times,emesis occurred 5 case-times,cough occurred 2 case-times,diarrhea occurred 1 case-time; convulsion occurred 6 case-times（ including 1 case with 1 time of convulsion,2 cases with 2 to 10 times of convulsion,3 cases with over 10 times of convulsion）,paroxysmal blindness/blurred vision occurred 4 case-times,conscious disturbance occurred 4 case-times. Blood culture results of the 10 children were all negative,routine cerebrospinal fluid examination results were normal; 1 child with elevated WBC（ 21. 9 ×10~9/L） and neutrophil fraction（ 75. 88%）; 1 child with reduced blood natrium（ 131 mmol/L）. Cerebral MRI examination results of the 10 children showed flake-like long T1 signal intensity and long T2 signal intensity,DWI showed increased signal intensity,thereinto 1 child found symmetric multiple long T1 signal intensity and long T2 signal intensity in bilateral centrum semiovale and partial temporal lobe white matter,meanwhile DWI showed increased signal intensity,who was finally diagnosed type Ⅱ slight encephalitis complicated with reversible lesions of corpus callosum splenium. All of the 10 children received conventional anti-inflammatory therapy,anti-virus therapy,dehydration and intracranial pressure reduction treatment; during the 4 months to 2 years follow-up, all of the 10 children＇ nervous system developed normally. Conclusion Clinical manifestations and imaging features of slight encephalitis children complicated with reversible lesions of corpus callosum splenium are characteristic,but the prognosis is good after relevant clinical treatment.
出处
《实用心脑肺血管病杂志》
2017年第9期82-85,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
脑炎
儿童
胼胝体
影像学
Encephalitis
Child
Corpus callosum
Imaging
